Circumcision linked to lowered prostate cancer risk

NEW YORK (Reuters) - Something about being circumcised may
offer men a degree of protection from developing prostate cancer
later in life, suggests a new study from Canada.

Researchers suspect the connection may be the lower rate
among circumcised men of sexually transmitted diseases (STD),
which raise prostate cancer risk, but they caution that more
study is needed to confirm that theory.

"It's still premature to say go ahead with circumcision to
prevent prostate cancer," said lead author Marie-Elise Parent.
"But, we think it could be helpful."

Based on interviews with more than 3,000 men, her team found
that those circumcised as infants were 14 percent less likely
than uncircumcised men to develop prostate cancer. The men who
had been circumcised as adults were 45 percent less likely to
develop the cancer than uncircumcised men.

Researchers have long known that Muslim and Jewish men have
lower rates of prostate cancer than men in the West, suggesting
that circumcision may play a role in cancer risk, the study team
writes in the British urology journal BJU International.

To investigate the connection, Parent, a cancer
epidemiologist at the University of Quebec's INRS-Institut
Armand-Frappier in Montreal, and her colleagues recruited 3,208
men in the Montreal area.

The participants were all between 40 and 75 years old when
they were recruited and 1,590 of them had been diagnosed with
prostate cancer. The other 1,618 men did not have prostate
cancer but were otherwise similar in health and age.

Between 2006 and 2011, all the men were interviewed at home,
with in-depth questions about their health and lifestyle,
medical history, family history of cancer and work history.

Overall, 40 percent of white men and 30 percent of black men
interviewed were circumcised.

For the entire group, researchers found an 11 percent lower
risk of having prostate cancer among circumcised men, but noted
that it was not statistically significant, meaning it could have
been due to chance.

The team did find a significant difference among circumcised
black men, who were 60 percent less likely than uncircumcised
men to have prostate cancer.

"Black men have the highest rate (of prostate cancer) on the
planet and we don't know why," Parent told Reuters Health. "It's
really puzzling trying to figure out why this cancer is so
common in men that live in industrialized countries, when we
understand so little about what's going on with it and have no
way of preventing it."

The National Cancer Institute estimates that in the U.S.,
almost three million men are living with prostate cancer. It is
the second leading cause of cancer deaths among men.

About 79 percent of U.S. men born in the 1970s and 1980s
were circumcised as babies, according to Dr. Aaron Tobian of
Johns Hopkins University in Baltimore, Maryland. But the
circumcision rate has been declining, he told Reuters Health.

Among males born in the U.S. in 1999, 62.5 percent were
circumcised, and by 2010, the rate among newborns was below 55
percent, Tobian said.

Medicaid does not typically cover the procedure, which could
lead to exaggerated socio-economic differences in STD-related
health, Tobian added. "Insurers are also trending toward
decreasing coverage for circumcision," he said.

Dr. Christopher Cooper, a professor and urologist at the
University of Iowa told Reuters Health that the Canadian study
does not justify promoting circumcision as prostate cancer
prevention

The number of black men studied was too small for any
conclusions to be drawn, he notes. Only 103 of the participants
with prostate cancer were black men, and only 75 of the healthy
men in the comparison group were black.

"The STD mechanism is possible but quite a stretch," Cooper
said. He also pointed out that there were certain factors the
researchers could not control in the study, such as how honest
participants were about having STDs or, among the men
circumcised as adults, the reason for their circumcision.

Parent told Reuters Health that even though the study was
small, and she and her colleagues saw only a slightly reduced
risk later in life among men who were circumcised as babies, the
work is one more thing to consider when studying prostate
cancer.

"We are too early in the game to make it a public
recommendation. It could be that in the future it will be
confirmed that it's a good thing and may have an added
protection from other diseases," she added.

SOURCE: http://bit.ly/1mNIuIN BJU International, online May
28, 2014.

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